HIPAA NOTICE OF PRIVACY
PRACTICES
EFFECTIVE APRIL 14, 2003
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE
USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS
INFORMATION.
PLEASE REVIEW THIS INFORMATION CAREFULLY.
Note: If you have questions about this Notice, please contact
the Privacy Officer for Abbe, Inc. That person may be
contacted at: 319-398-3634. If you have questions regarding
your clinical records, please call the numbers listed with the
corporations below.
WHO WILL FOLLOW THIS NOTICE:
This notice describes the privacy practices of Abbe, Inc. and
its affiliates which include:
Abbe Center for Community Mental Health, Inc. 398-3562
Abbe Center for Community Care, Inc. 398-3534
Penn Center, Inc. 563-922-2881
Aging Services, Inc. 398-3644
Pentacrest, Inc. 339-6162
Kingston Hill 362-1382
“We” and “Abbe, Inc.” as used in this notice refer to Abbe,
Inc. and all of these affiliates and to all locations where
Abbe, Inc. and the other listed entities provide services to
you.
All employees of Abbe, Inc. as well as any health care
professional, whether an employee of Abbe, Inc. or not, who is
authorized to enter information into your chart may have
access to information in your chart for treatment, payment and
health care operations, and may use and disclose information
as described in this Notice. This Notice also applies to any
volunteer or trainee we allow to help you while seeking
services from us.
OUR PLEDGE REGARDING MEDICAL
INFORMATION:
Your medical information includes information about your
physical and mental health. We understand that information
about your physical and mental health is personal. We are
committed to protecting medical information about you. We
create a record of the care and services you receive at any of
Abbe, Inc.’s affiliates. We need this record to provide you
with quality care and to comply with certain legal
requirements. This Notice applies to all of the records of
your care generated by us. This Notice will tell you about the
ways in which we may use and disclose medical information
about you. We also describe your rights and certain
obligations we have regarding the use and disclosure of
medical information.
We reserve the right to revise or amend our Notice of Privacy
Practices without additional notice to you. Any revision or
amendment to this Notice will be effective for all of your
records we have created or maintained in the past, and for any
of your records we may create or maintain in the future. We
will post a copy of our current Notice and any amended Notice
in all of our locations in a prominent place and on our
website.
OUR OBLIGATIONS TO YOU
We are required by law to:
· make sure that medical information that identifies you is
kept private except as otherwise provided by state or federal
law;
· give you this notice of our legal duties and privacy
practices with respect to medical information about you; and
· follow the terms of the notice that is currently in effect.
HOW WE MAY USE AND DISCLOSE MEDICAL
INFORMATION ABOUT YOU:
Abbe, Inc. continues to follow disclosure procedures in
adherence to Iowa Code Chapter 228 Disclosure of Mental Health
and Psychological Information. Iowa law is more stringent
regarding disclosure of protected health information and
therefore takes precedence over the federal procedures.
The following categories describe different ways that we may
use and disclose medical information about you without your
consent or authorization. For each category of uses or
disclosures we will explain what we mean and try to give some
examples. Not every use or disclosure in a category will be
listed. This Notice covers treatment, payment, and what are
called health care operations, as discussed below. It also
covers other uses and disclosures for which a consent or
authorization are not necessary. Where Iowa law is more
protective of your medical information, we will follow state
law, as explained below.
For Treatment.
Once you have signed the acknowledgment provided with this
Notice, we may use medical information about you to provide
you with medical treatment or services unless otherwise
required by applicable Iowa law. We may disclose medical
information about you to doctors, nurses, medical students,
pharmacists or other health care providers, who are involved
in taking care of you whether or not they are affiliated with
Abbe, Inc.
For example, we may disclose medical information about your
physical health to your family physician or hospital or other
entity that has or will provide treatment or health care to
you. Abbe, Inc. continues to require an authorization of
disclosure in order to disclose specific mental health,
substance abuse or HIV/AIDS related information as required by
applicable Iowa law and federal regulations.
During the course of your treatment, we may refer you to other
health care providers such as independent laboratories with
which you may not have direct patient contact. These providers
are called "indirect treatment providers." "Indirect treatment
providers" are required to comply with the privacy
requirements of Iowa and federal law and keep your medical
information confidential.
For Payment.
We may use and disclose medical information about you so that
the treatment and services you receive at any affiliate may be
billed to and payment may be collected from you, an insurance
company or a third party. For example, we may need to give
your health plan information about treatment received so your
health plan will pay us or reimburse you for the treatment. We
may also tell your health plan about a treatment you are going
to receive to obtain prior approval or to determine whether
your plan will cover the treatment.
For Health Care Operations.
We may use and disclose medical information about you for
"health care operations." These uses and disclosures are
necessary to operate Abbe, Inc.’s affiliates and make sure
that all of our clients receive quality care. For example, we
may use medical information or mental health treatment
information to review our treatment and services and to
evaluate the performance of our staff in caring for you. We
may also disclose such information to doctors, nurses, medical
students and other Abbe, Inc. employees or consultants for
review and learning purposes.
Appointment Reminders.
Unless you tell us otherwise in writing, we may use and
disclose medical information to contact you as a reminder that
you have an appointment for treatment at any one of Abbe,
Inc.’s affiliates.
Treatment Alternatives.
We may use and disclose medical information to tell you about
or recommend possible treatment options or alternatives that
may be of interest to you. However, we will not use or
disclose medical information to market other products and
services, either ours or those of third parties, without your
authorization.
Health-Related Benefits and Services.
We may use and disclose medical information to tell you about
health-related benefits or services that may be of interest to
you.
Individuals Involved in Your Care or
Payment for Your Care.
We may release medical information, including mental health
information, about you to a family member who is involved in
your medical care without consent or authorization if the
individual's involvement is related to such information. We
may also give medical information, including prescription
information or information concerning your appointments to
friends who are involved in your care only as allowed by Iowa
law. We may also give such information to someone who helps
pay for your care. In addition, we may disclose medical
information about you to an entity assisting in a disaster
relief effort so that your family can be notified about your
condition, status, and location.
Fundraising.
Abbe, Inc. or a consultant employed by Abbe, Inc. or
affiliates may contact you about raising funds.
As Required By Law.
We will disclose medical information about you when required
to do so by federal, state or local law.
To Avert a Serious Threat to Health
or Safety.
We may disclose medical information about you when necessary
to prevent a serious threat to your health and safety or the
health and safety of the public or another person. Any
disclosure, however, would only be to someone able to help
prevent the threat.
To Business Associates.
Abbe, Inc. and its affiliates from time to time will hire
consultants, known as "business associates"; who render
services to Abbe, Inc. and its affiliates. We may disclose
your medical information to such consultants. Business
associates are required to maintain and comply with the
privacy requirements of state and federal law and keep your
medical information confidential. Examples of "business
associates" are accounting firms that are hired to perform
audits of billing and payment information, and computer
software vendors who assist Abbe, Inc. in maintaining and
processing medical information.
Military and Veterans.
If you are a member of the armed forces, we may release
medical information about you as required by military command
authorities. We may also release medical information about
foreign military personnel to the appropriate foreign military
authority.
Worker’s Compensation.
We may release medical information about you for workers’
compensation or similar programs. These programs provide
benefits for work-related injuries or illnesses.
Public Health Risks.
We may disclose medical information about you for public
health activities. These activities generally include the
following:
• to prevent or control disease, injury or disability;
• to report reactions to medications or problems with
products;
• to notify people of recalls of products they may be using;
• to notify a person who may have been exposed to a disease or
may be at risk for contracting or spreading a disease or
condition;
• to notify the appropriate government authority if we believe
a patient has been the victim of abuse, neglect or domestic
violence. We will only make this disclosure if you agree to
when required or authorized by law.
Health Oversight Activities.
We may disclose medical information to a health oversight
agency for activities authorized by law. These oversight
activities include, for example, audits, investigations,
inspections, and licensure. These activities are necessary for
the government to monitor the health care system, government
programs, and compliance with civil rights laws.
Lawsuits and Administrative
Proceedings.
If you are involved in a lawsuit or dispute, we may disclose
medical information about you in response to a court or
administrative order. We may also disclose medical information
about you in response to a subpoena, discovery request, or
other lawful process by someone else involved in the dispute,
but only if efforts have been made to tell you or your
attorney about the request or to obtain an order protecting
the information requested. In addition, we may disclose
medical information, including mental health treatment
information, to the opposing party in any lawsuit or
administrative proceeding where you have put your physical or
mental condition at issue.
Law Enforcement.
We may release medical information if asked to do so by a law
enforcement official:
• in response to a court order, subpoena, warrant, summons or
similar process;
• to identify or locate a suspect, fugitive, material witness,
or missing person;
• about the victim of a crime if, under certain limited
circumstances, we are unable to obtain the person’s agreement;
• about a death we believe may be the result of criminal
conduct;
• about criminal conduct at Abbe, Inc. or its affiliates; and
• in emergency circumstances to report a crime; the location
of the crime or victims; or the identity, description or
location of the person who committed the crime.
Coroners, Medical Examiners and
Funeral Directors.
We may release medical information to a coroner or medical
examiner. This may be necessary, for example, to identify a
deceased person or determine the cause of death.
National Security and Intelligence
Activities.
We may release medical information about you to authorized
federal officials for intelligence, counterintelligence, and
other national security activities authorized by law.
Protective Services for the President
and Others.
We may disclose medical information about you to authorized
federal officials so they may provide protection to the
President, other authorized persons or foreign heads of state
or conduct special investigations.
Inmates.
If you are an inmate of a correctional institution or under
the custody of a law enforcement official, we may release
medical information about you to the correctional institution
or law enforcement official. This release would be necessary
(1) for the institution to provide you with health care; (2)
to protect your health and safety or the health and safety of
others; or (3) for the safety and security of the correctional
institution
You have the following rights regarding medical information we
maintain about you:
Right to Inspect and Copy.
You have the right to inspect and copy medical information
that may be used to make decisions about your care. Usually,
this includes medical and billing records, but does not
include psychotherapy notes.
To inspect and copy medical information that may be used to
make decisions about you, you must submit your request in
writing to the Privacy Officer at Abbe Inc., 1860 County Home Road,
Marion, Iowa 52302, 319-398-3634. If you request a
copy of the information, we may charge a reasonable fee for
the costs of copying, mailing and or other supplies associated
with your request.
We may deny your request to inspect and copy in certain very
limited circumstances. If you are denied access to medical
information, you may request that the denial be reviewed.
Another licensed health care professional chosen by Abbe, Inc.
or its affiliates will review your request and the denial. The
person conducting the review will not be the person who denied
your request. We will comply with the outcome of the review.
Right to Request Amendment.
If you feel that medical information we have about you is
incorrect or incomplete, you may ask us to amend the
information. You have the right to request an amendment for as
long as the information is kept by or for Abbe, Inc. if the
information is contained in our designated record set, which
usually includes medical and billing records, but does not
include psychotherapy notes.
To request an amendment, your request must be made in writing
and submitted to the Privacy Officer. In addition, you must
provide a reason that supports your request.
We may deny your request for an amendment if it is not in
writing or does not include a reason to support the request.
In addition, we may deny your request if you ask us to amend
information that:
• Was not created by us, unless the person or entity that
created the information
is no longer available to make that amendment;
• Is not part of the medical information kept by Abbe, Inc. or
its affiliates;
• Is not part of the information which you would be permitted
to inspect and
copy; or
• Is accurate and complete.
Right to an Accounting of
Disclosures.
You have the right to request an “accounting of disclosures.”
This is a list of the disclosures we made of medical
information about you that are not disclosures for treatment,
payment and health care operations.
To request this list or accounting of disclosures, you must
submit your request in writing to the Privacy Officer. Your
request must state a time period, which may not be longer than
six years. Your request will be provided to you on paper. The
first list you request within a 12-month period will be free.
For additional lists, we may charge you for the costs of
providing the list. We will notify you of the cost involved
and you may choose to withdraw or modify your request at that
time before any costs are incurred.
Right to Request Restrictions.
You have the right to request a restriction or limitation on
the mental health treatment or other medical information we
use or disclose about you for treatment, payment or health
care operations. You also have the right to request a limit on
the medical information we disclose about you to someone who
is involved in your care or the payment for your care, like a
family member or friend. For example, you may request that
your spouse or child who is involved in your care not receive
certain information about your condition.
We are not required to agree to your request. If we do agree,
we will comply with your request unless the information is
needed to provide you emergency treatment.
To request restrictions, you must make your request in writing
to the Privacy Officer. In your request, you must tell us (1)
what information you want to limit; (2) whether you want to
limit our use, disclosure or both; and (3) to whom you want
the limits to apply, for example, disclosures to your spouse.
Right to Request Confidential
Communications.
You have the right to request that we communicate with you
about medical matters in a certain way or at a certain
location. For example, you can ask that we only contact you at
work or by mail.
To request confidential communications, you must make your
request in writing to the Privacy Officer. We will not ask the
reason for your request. We will accommodate all reasonable
requests. Your request must specify how or where you wish to
be contacted.
Right to a Paper Copy of This Notice.
You have the right to a paper copy of this Notice. You may ask
us to give you a copy of this notice at any time. Even if you
have agreed to receive this notice electronically, you are
still entitled to a paper copy of this Notice.
You may obtain a copy of this notice at our web site,
www.abbe.org.
To obtain a paper copy of this Notice contact Abbe, Inc. at
1860 County Home Road, Marion, Iowa 52302 or call
319-398-3634.
COMPLAINTS. If you believe
your privacy rights have been violated, you may file a
complaint with Abbe, Inc. or any of its affiliates or with the
Secretary of the Department of Health and Human Services. To
file a complaint with Abbe, Inc. contact Michele Wray, Privacy
Officer, 319-398-3634. All complaints must be submitted in
writing. You will not be penalized for filing a complaint.
OTHER USES OF MEDICAL INFORMATION.
Other uses and disclosures of medical information
not covered by this Notice or the laws that apply to us will
be made only with your written permission as set out in an
authorization signed by you. If you provide us permission to
use or disclose medical information about you, you may revoke
that permission, in writing, at any time. If you revoke your
permission, we will no longer use or disclose medical
information about you for the reasons covered by your written
authorization. You understand that we are unable to take back
any disclosures we have already made with your permission, and
that we are required to retain our records of the care that we
provided to you.
Red Flag Rules: The
Federal Trade Commission has enacted an Identity Theft
Prevention Red Flag rule. This program identifies Red Flags
based on risk factors associated with Abbe’s Covered accounts.
Covered accounts include billing statements and client payment
plans. If you feel there has been a HIPPA Security Compromise,
please contact Abbe’s Security Officer at 398-3634
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